Routine inspection·November 19, 2024

At approximately 1:10PM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Required 1-Year Visit and met with Staff Member, Tigist Dinka. Administrator, Miriam Ghezzehai, was available by telephone. Facility is a Residential Home for the Elderly and provides care and assistance for Older Adults. Facility has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and capacity for 6 non-ambulatory residents. Facility has an approved hospice waiver for 3 individuals. Upon arrival, LPA was informed that there were 6 residents in care, and 2 staff members on-site. At approximately 1:20PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 1:25PM, LPA conducted a walk-though of the facility. LPA observed the following: The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a 1 story building with 6 Resident bedrooms, 4 bathrooms, a staff break room and common spaces. Facility has an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for Residents. Mattress pads were in place or available for Resident use. During walkthrough, LPA observed the following to be unlocked and accessible to residents in care: clorox jug outside in the backyard, scissors in the cabinet of a resident bathroom, and multiple cleaning supplies underneath the kitchen sink (deficiency cited, LIC809D, regulation 87705(f)). LPA observed that the lock for the kitchen sink cabinet was broken. Staff Member immediately place all toxins in the garage. LPA also observed that all sinks accessible to residents were out of compliance with Title 22 Regulations, measuring at 131.1F, 134.4F, 123.0F, 121.8F, 120.9F, and 121.1F (deficiency cited, LIC809D, regulation 87303(e)(2)). Facility's fire extinguishers were last inspected February 2023. Facility's last fire drill was conducted October 2024. LPA unable to complete the Annual Inspection. Annual Continuation Visit to be conducted at a later date. Continued on LIC809C Continued from LIC809 Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC809D (Deficiency Page), Plan of Corrections, and Appeal Rights discussed and provided to Staff Member. Signature on form confirms receipt of documents.